
Hepatocellular carcinoma (HCC) is currently one of the most frequent malignant tumors worldwide and the second leading cause of cancer-related deaths (Bray et al., 2018; Piñero et al., 2020). HCC accounts for 80% (main type) of all malignant primary liver cancers. HCC is caused by various risk factors such as excessive alcohol consumption, obesity, smoking, type 2 diabetes, and chronic hepatitis B and C virus infections (Gomes et al., 2013; Singal and El-Serag, 2015). Since most patients with HCC are asymptomatic, its diagnosis is challenging in the early stages and mainly diagnosed at an advanced stage with poor prognosis owing to cancer progression (Ling et al., 2014). Surgical resection and drugs, which are conventional treatment methods for HCC, are not effective in most patients, and the prognosis is poor owing to frequent recurrence (Gu et al., 2020). The 5-year survival rate of patients with HCC is approximately 3~5%, and early diagnosis of HCC is essential to increase the survival rate (Yu, 2016). Therefore, it is necessary to develop a new biomarker to increase the early diagnosis and survival rate of patients with HCC. Additionally, to create an effective treatment strategy, research on the molecular etiology of HCC must be conducted. Therefore, the discovery of prognostic biomarkers is very important for the diagnosis and treatment of patients with HCC.
The immune system plays a major role in controlling the progression of cancer, and among them, the roles of the tumor immune microenvironment (TIME) and tumor-infiltrating immune cells (TIICs) are drawing attention (Gentles et al., 2015; Schreiber et al., 2011). The TIME in HCC consists of immune cells such as neutrophils, macrophages, dendritic cells, CD4+ T cells, CD8+ T cells, natural killer cells, and B cells, which play an important role in tumor progression in HCC. In addition, it plays an important role in predicting the prognosis of patients with HCC (Soo et al., 2018). TIME is correlated with cancer incidence and is also regulated by TIICs (Lazăr et al., 2018). Thus far, TIICs have been used as a predictor of clinical outcomes in treating cancer (Bense et al., 2016; Zhang et al., 2019). Therefore, the results of the patient's showing accumulated TIICs play an important role as prognostic indicators.
The sterile alpha motif (SAM) domain is a protein found in the eukaryotic genome that creates large protein complexes in cells and binds to various proteins, lipids, and RNAs (Ray et al., 2020). Certain SAM domains have been identified as functional. SAM domain 9 is responsible for regulating cell proliferation and inhibiting neoplasms. SAM domain 5 expression is associated with the regulation of the cell cycle of cholangiocarcinoma (CC) cells
In this study, we used the Tumor Immune Estimation Resource (TIMER), Gene Expression Profiling Interactive Analysis2 (GEPIA2), and Kaplan-Meier (KM) plotter database programs to analyze the correlation between SAMD13 expression in patients with HCC and investigated the correlation between SAMD13 and TIICs. Additionally, we identified a joint expression network with SAMD13 using LinkedOmics. Our results potentially seek to uncover strategies for the diagnosis and treatment of HCC by using SAMD13.
TIMER has been used to systematically analyze TIICs in diverse cancer types (Li et al., 2017). The TIMER systematic database includes >10,000 tumor samples across 32 cancer types from The Cancer Genome Atlas (TCGA). The expression of SAMD13 has been studied in various cancer types. We also determined the correlation between SAMD13 and infiltrating immune cells (CD4+ T cells, CD8+ T cells, neutrophils, macrophages, dendritic cells, and B cells) in HCC.
The prognostic value of SAMD13 was confirmed using OSlihc (An et al., 2020). To evaluate the prognostic value of genes in OSlihc, survival terms including overall survival (OS), disease-free interval (DFI), progression-free interval (PFI), and disease-specific survival (DSS) were generated, and OS was measured in all cohorts and combined cohorts, while DFI, PFI, and DSS were analyzed using TCGA.
UALCAN uses TCGA level 3 RNA sequence and clinical data from >30 cancer types (Chandrashekar et al., 2017), allowing the analysis of the relative expression of genes across tumor and normal samples as well as in various tumor subgroups based on individual cancer stages, tumor grades, or other clinicopathological features.
The KM database is based on an online database (Györffy et al., 2010). It can estimate the effect of >54,000 genes on survival using >10,000 cancer samples and can be used to confirm the association of genes with survival in various types of cancer, including HCC. KM includes survival rates (OS, relapse-free survival [RFS], progression-free survival [PFS], and DSS) and clinicopathological characteristics data (sex, race, stage, grade, AJCC_T, vascular invasion, alcohol consumption, and hepatitis virus) in HCC. The correlations between SAMD13 and survival rates were identified and presented with the hazard ratio (HR), 95% confidence intervals, and the log rank
The LinkedOmics database is a platform for analyzing TCGA cancer-related multi-dimensional datasets (Vasaikar et al., 2018). Genes co-expressed with SAMD13 were statistically represented using Pearson's correlation coefficient and presented as heat maps or scatter plots. The function module of LinkedOmics analyzes Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathways along with transcription factor-target enrichment by gene set enrichment analysis. The rank criteria were FDR<0.05, and 500 simulations were performed.
The GEPIA2 database is an interactive web that includes >9,700 tumor samples and >8,500 normal tissue samples from TCGA and Genotype-Tissue Expression (GTEx) projects (Tang et al., 2017). GEPIA2 was used to generate survival curves, such as OS and DFS, based on the gene expression levels in 33 cancer types. GEPIA2 provides heat maps based on survival outcomes in different types of cancer (Tang et al., 2019). Heatmaps of OS and DFS based on SAMD13 expression across TCGA cancer types were obtained using the "Survival Map". GEPIA2 showed survival curves based on SAMD-13 expression using the log-rank test and Mantel-Cox test.
In this study, all data were derived from an open database, and all analyses were confirmed using web tools. All results are expressed as
To determine the differences in SAMD13 mRNA expression between tumor and normal tissues, SAMD13 expression in normal tissues and different tumor types, including HCC, was studied using TIMER. The expression levels were higher in HCC, glioblastoma multiforme (GBM), kidney renal papillary cell carcinoma (KIRP), liver HCC (LIHC), prostate adenocarcinoma (PRAD), stomach adenocarcinoma (STAD), and head and neck squamous cell carcinoma, human papillomavirus (HNSC-HPV+) than in normal tissues. Nevertheless, the expression levels of SAMD13 were lower in breast invasive carcinoma (BRCA), colon adenocarcinoma (COAD), head and neck squamous cell carcinoma (HNSC), kidney chromophobe (KICH), kidney renal clear cell carcinoma (KIRC), pheochromocytoma and paraganglioma (PCPG), rectum adenocarcinoma (READ), thyroid carcinoma (THCA), and uterine corpus endometrial carcinoma (UCEC) than in normal tissues (Fig. 1A). Based on these results, the comparison of primary tumors and healthy tissue samples, pathological staging, tumor grade, and nodal metastasis status were analyzed using UALCAN. The expression of SAMD13 in LIHC samples was higher than that in normal liver tissue (Fig. 1B). For individual cancer stages, the expression of SAMD13 in stages 1, 2, 3, and 4 was higher than that in the normal liver tissues (Fig. 1C). In addition, the expression of SAMD13 in grades 1, 2, 3, and 4 was higher than that in the normal liver tissues (Fig. 1D). Regarding nodal metastasis status, the expression of SAMD-13 in N0 was higher than that in normal liver tissues (Fig. 1E).
We investigated whether SAMD13 expression correlated with HCC prognosis. Therefore, the effect of SAMD13 expression on survival rates was evaluated using the KM plotter, OSlihc web server, GEPIA database, and PrognoScan databases. Survival rates, such as OS, RFS, PFS, and DSS, of SAMD13 in HCC were analyzed. The findings revealed that patients with high SAMD13 expression had significantly shorter survival times than those with low expression (Fig. 2A). High SAMD13 expression was associated with poor prognosis in HCC (OS, HR = 1.86,
We investigated the correlation between SAMD13 expression and clinicopathological characteristics of HCC. Higher SAMD13 expression correlated with poorer prognosis in the following clinical features: sex (HR = 1.37,
Correlation between SAMD13 and clinicopathological characteristics in HCC
Clinicopathological characteristics | Overall survival ( |
Relapse free survival ( |
Progression free survival ( |
Disease specific survival ( |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Hazard ratio | N | Hazard ratio | N | Hazard ratio | N | Hazard ratio | ||||||||
SEX | |||||||||||||||
Male | 246 | 2.63 (1.64~4.21) |
3e-05 | 210 | 1.38 (0.92~2.05) |
0.11 | 149 | 1.45 (1.01~2.07) |
0.043 | 244 | 2.79 (1.53~5.09) |
0.00049 | |||
Female | 118 | 1.5 (0.85~2.66) |
0.16 | 106 | 1.46 (0.81~2.64) |
0.21 | 121 | 1.61 (0.96~2.7) |
0.07 | 118 | 2.04 (0.98~4.25) |
0.052 | |||
STAGE | |||||||||||||||
I | 170 | 1.45 (0.79~2.67) |
0.23 | 153 | 1.16 (0.68~1.99) |
0.59 | 171 | 1.18 (0.72~1.94) |
0.51 | 168 | 1.63 (0.67~3.96) |
0.28 | |||
I+II | 253 | 1.82 (1.12~2.95) |
0.014 | 228 | 1.36 (0.9~2.06) |
0.15 | 256 | 1.45 (0.99~2.12) |
0.053 | 251 | 2.75 (1.33~5.69) |
0.0044 | |||
II | 83 | 2.7 (1.16~6.27) |
0.016 | 75 | 0.87 (0.45~1.69) |
0.68 | 85 | 1.09 (0.61~1.97) |
0.77 | 83 | 3.19 (0.98~10.4) |
0.042 | |||
II+III | 166 | 2.17 (1.33~3.54) |
0.0015 | 145 | 1.24 (0.8~1.93) |
0.34 | 170 | 1.25 (0.84~1.85) |
0.28 | 166 | 2.12 (1.15~3.92) |
0.014 | |||
III | 83 | 2.09 (1.13~3.84) |
0.016 | 70 | 1.77 (0.97~3.23) |
0.062 | 85 | 1.4 (0.82~2.41) |
0.22 | 83 | 1.64 (0.8~3.36) |
0.17 | |||
III+IV | 87 | 1.74 (0.97~3.11) |
0.058 | 70 | 1.77 (0.97~3.23) |
0.062 | 90 | 1.41 (0.83~2.39) |
0.2 | 87 | 1.56 (0.78~3.13) |
0.21 | |||
IV | 4 | - | - | 0 | - | 5 | - | - | 3 | - | - | ||||
GRADE | |||||||||||||||
I | 65 | 2.05 (0.78~5.39) |
0.14 | 55 | 1.96 (0.74~5.23) |
0.17 | 55 | 4 (1.7~9.41) |
0.00067 | 55 | 5.11 (1.29~20.22) |
0.011 | |||
II | 174 | 2 (1.18~3.38) |
0.0086 | 149 | 1.38 (0.85~2.25) |
0.19 | 177 | 1.36 (0.88~2.1) |
0.16 | 171 | 2.03 (1.03~3.97) |
0.036 | |||
III | 118 | 2.02 (1.09~3.77) |
0.023 | 107 | 1.28 (0.75~2.18) |
0.37 | 121 | 1.29 (0.78~2.12) |
0.32 | 119 | 1.78 (0.83~3.82) |
0.13 | |||
IV | 12 | - | - | 11 | - | - | 12 | - | - | 12 | - | - | |||
AJCC_T | |||||||||||||||
I | 180 | 1.37 (0.77~2.46) |
0.28 | 160 | 1.16 (0.69~1.97) |
0.57 | 181 | 1.18 (0.73~1.91) |
0.49 | 178 | 1.4 (0.62~3.13) |
0.41 | |||
II | 90 | 2.52 (1.17~5.43) |
0.015 | 80 | 0.91 (0.49~1.71) |
0.77 | 93 | 1.15 (0.67~1.99) |
0.61 | 91 | 2.74 (1.01~7.42) |
0.039 | |||
III | 78 | 2.12 (1.13~3.96) |
0.016 | 67 | 1.59 (0.85~2.96) |
0.14 | 80 | 1.25 (0.71~2.19) |
0.44 | 77 | 1.72 (0.81~3.65) |
0.15 | |||
IV | 13 | - | 6 | 13 | 13 | - | - | ||||||||
Vascular invasion | |||||||||||||||
None | 203 | 1.46 (0.87~2.44) |
0.15 | 175 | 1.09 (0.68~1.77) |
0.71 | 205 | 1.05 (0.67~1.64) |
0.83 | 201 | 1.37 (0.67~2.8) |
0.38 | |||
Micro | 90 | 1.5 (0.7~3.21) |
0.29 | 82 | 1.13 (0.6~2.12) |
0.71 | 92 | 1.25 (0.71~2.21) |
0.43 | 90 | 1.44 (0.48~4.28) |
0.51 | |||
Macro | 16 | - | - | 14 | - | - | 16 | - | - | 14 | - | - | |||
RACE | |||||||||||||||
White | 181 | 1.55 (0.98~2.47) |
0.059 | 147 | 1.58 (1~2.49) |
0.046 | 184 | 1.57 (1.05~2.33) |
0.026 | 179 | 2.23 (1.24~4) |
0.006 | |||
Asian | 154 | 2.57 (1.37~4.81) |
0.0022 | 145 | 1.35 (0.82~2.24) |
0.24 | 157 | 1.6 (1~2.57) |
0.048 | 154 | 2.4 (1.08~5.37) |
0.028 | |||
Alcohol consumption | |||||||||||||||
Yes | 115 | 1.27 (0.67~2.39) |
0.46 | 99 | 0.94 (0.53~1.68) |
0.84 | 117 | 1.07 (0.64~1.79) |
0.79 | 117 | 1.14 (0.56~2.32) |
0.72 | |||
None | 202 | 1.81 (1.14~2.88) |
0.011 | 183 | 1.43 (0.92~2.22) |
0.11 | 205 | 1.47 (0.99~2.21) |
0.057 | 199 | 2.15 (1.14~4.04) |
0.015 | |||
Hepatitis virus | |||||||||||||||
Yes | 150 | 1.23 (0.64~2.34) |
0.54 | 139 | 0.93 (0.57~1.53) |
0.78 | 153 | 1.07 (0.67~1.69) |
0.78 | 151 | 1.76 (0.77~4.02) |
0.18 | |||
None | 167 | 1.79 (1.13~2.84) |
0.012 | 133 | 1.58 (0.95~2.6) |
0.074 | 169 | 1.63 (1.05~2.53) |
0.028 | 165 | 1.95 (1.09~3.47) |
0.021 |
We explored the correlation between SAMD13 and infiltrating immune cells in HCC by using the TIMER database. The results revealed that SAMD13 significantly and positively correlated with the infiltration levels of CD8+ T cells (R = 0.045,
To explore the biological functions involving SAMD13 in HCC, the LinkedOmics module was used to obtain the co-expression patterns of SAMD13. In total, 6804 genes showed a negative correlation with SAMD13, while 13110 genes showed a positive correlation (Fig. 5A). The heatmaps showed that the top 50 genes were positively and negatively associated with SAMD13 (Figs. 5B, C). GO biological analysis indicated that the genes co-expressed with SAMD13 mainly participated in protein localization to chromosomes, rRNA metabolic processes, ncRNA processing, ribonucleoprotein complex biogenesis, and negative chemotaxis (Fig. 5D). Furthermore, the SAMD13 pathway analysis indicated that the co-expressed genes of SAMD13 were mainly enriched in the spliceosome, ribosome biogenesis in eukaryotes, ribosomes, aminoacyl-tRNA biosynthesis, and homologous recombination (Fig. 5E). SAMD13 showed a positive association with expression of E2F5 (R = 0.4186,
Thirty-seven genes had a high HR (
Liver cancer, with high tumor-related mortality worldwide, is divided into three major pathological types: HCC, intrahepatic CC, and combined HCC/CC. It shows differences in pathogenesis, histological form, treatment, and prognosis. As HCC is initially asymptomatic and diagnostically challenging in the early stages, it is diagnosed in the later stages (progressive state) of HCC (Kulik and El-Serag, 2019; Wallace et al., 2015) As a result, the prognosis after HCC diagnosis is very poor. Therefore, there is an increasing need for research on biomarker development that can aid in early diagnosis.
Cells of the immune system that play an important role in controlling cancer progression, can also accelerate cancer progression (Goswami et al., 2017; Ostrand-Rosenberg, 2008). For example, TIICs aid in the growth of cancer cells and tumors (Bremnes et al., 2011). TIICs and tumors are closely related to clinical outcomes and help predict patient responses before cancer treatment (Choi et al., 2017). Over the years, HCC-related TIICs have been identified as having the prognostic value of immune molecules (Harding et al., 2019; Ma et al., 2018; Sun et al., 2019; Tian et al., 2019; Yang et al., 2019).
We studied the expression levels of SAMD13 in HCC using the TIMER and UALCAN databases. Differential expression of SAMD13 between tumor and normal tissues has been observed in a variety of cancers. We showed that SAMD13 expression was higher in HCC than in normal adjacent tissues. Based on the UALCAN database, SAMD-13 expression was higher in primary tumors, cancer stage (I, II, III, IIII), tumor grade (I, II, III, IIII), and nodal metastasis status (N0) in HCC. Based on these results, we identified the prognostic significance of high SAMD13 expression in HCC. Analysis of the KM plotter, Oslihc, and GEPIA revealed that high expression of SAMD13 correlated with poor prognosis in HCC. We found that high expression of SAMD13 correlated with a high HR for poor survival rate. In addition, the TIMER database identified that high SAMD-13 expression was correlated with poor prognosis in male patients, stages, grades, race, alcohol consumption, and hepatitis virus infection in HCC. These results suggest that SAMD13 may be a prognostic biomarker for HCC.
An important aspect of our study was that SAMD13 expression correlated with the level of immune infiltration in HCC. We confirmed that the infiltration levels of CD8+ T cells, CD4+ T cells, B cells, neutrophils, macrophages, and dendritic cells were correlated with SAMD13 expression levels. Moreover, we showed that high SAMD13 expression levels correlated with poor prognosis of infiltrating immune cells. The results showed that high SAMD13 expression and high CD8+ and CD4+ T cell infiltration levels were associated with a worse prognosis than low SAMD13 expression and low CD8+ and CD4+ T cell infiltration levels. High SAMD13 expression and high B cell infiltration levels had a worse prognosis than low SAMD13 expression and low B cell infiltration levels. High SAMD13 expression and high neutrophil infiltration levels had a worse prognosis than low SAMD13 expression and low neutrophil infiltration levels. High SAMD13 expression and high macrophage infiltration levels had a worse prognosis than low SAMD13 expression and low macrophage infiltration levels. High SAMD13 expression and high dendritic cell infiltration levels had a worse prognosis than low SAMD13 expression and low dendritic cell infiltration levels. These results suggest that high SAMD13 expression and immune cell infiltration are associated with poor prognosis.
By analyzing the SAMD13 co-expression network, genes with positive and negative correlations were identified. SAMD13 has been confirmed to affect the prognosis of patients with HCC. SAMD13-related positive genes indicated that 37 genes had a high HR for OS, and 18 genes had a high HR for DFS. SAMD13-related negative genes indicated a low HR of 14 genes in OS, and 7 genes indicated a low HR in DFS. According to the biological functions of SAMD13 the in HCC, we identified that the functional consequences of SAMD13 mainly include protein localization to chromosomes, rRNA metabolic processes, ncRNA processing, ribonucleoprotein complex biogenesis, and negative chemotaxis, while it inhibits processes including peroxisome organization, peroxisomal transport, tricarboxylic acid metabolic process, and regulation of carbohydrate metabolic processes.
In conclusion, we showed that high SAMD13 expression is associated with poor prognosis and tumor infiltration of immune cells in HCC. Therefore, this study demonstrates the significance of SAMD13 as a novel prognostic biomarker for HCC. These results can be used as data for identifying potential targets of immunotherapy in HCC. These data may help understand the role of SAMD13 in various cancers, including HCC, and further studies should be undertaken to outline its detailed mechanisms.
This work was supported by the National Research Foundation of Korea (NRF) funded by the Korea government (MSIT) (RS-2022-00165637, NRF-2021R1C1C1003333).
Authors declare no competing interests.